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PubMed2006

Clinical and theoretical parallels between desire for limb amputation and gender identity disorder.

Desire for amputation of a healthy limb has usually been regarded as a paraphilia (apotemnophilia), but some researchers propose that it may be a disorder of identity, similar to Gender Identity Disorder (GID) or transsexualism. Similarities between the desire for limb amputation and nonhomosexual male-to-female (MtF) transsexualism include profound dissatisfaction with embodiment, related paraphilias from which the conditions plausibly derive (apotemnophilia and autogynephilia), sexual arousal from simulation of the sought-after status (pretending to be an amputee and transvestism), attraction to persons with the same body type one wants to acquire, and an elevated prevalence of other paraphilic interests. K. Freund and R. Blanchard (1993) proposed that nonhomosexual MtF transsexualism represents an erotic target location error, in which men whose preferred erotic targets are women also eroticize their own feminized bodies. Desire for limb amputation may also reflect an erotic target location error, occurring in combination with an unusual erotic target preference for amputees. This model predicts that persons who desire limb amputation would almost always be attracted to amputees and would display an increased prevalence of gender identity problems, both of which have been observed. Persons who desire limb amputation and nonhomosexual MtF transsexuals often assert that their motives for wanting to change their bodies reflect issues of identity rather than sexuality, but because erotic/romantic orientations contribute significantly to identity, such distinctions may not be meaningful. Experience with nonhomosexual MtF transsexualism suggests possible directions for research and treatment for persons who desire limb amputation.

Amputation, Surgical↗
PubMed1995

Gender identity disorder in a girl: insights from adoption.

Gender identity disorder in girls is reported far less frequently than in boys. The analysis of a six-year-old adopted girl with gender identity disorder is presented to show the importance of the mother-infant relationship and of parental, especially maternal, attitudes toward gender in the normal development of gender identity and gender role definition. This child's unusual history included a late adoption, with clear evidence of separation trauma, and the ongoing influence of maternal infertility. Her symptoms of gender identity disorder appeared before her second birthday and were well established by three years of age. The analysis, from age six to thirteen, achieved a better adaptation to her gender. Her masculine strivings gradually became incorporated into an essentially feminine orientation.

Adolescent↗
PubMed1995

A clinical approach to childhood gender identity disorder.

A review of gender identity disorder is presented along with a case of a four-year-old boy. An overview of some of the theories of gender identity disorder directs our attention via the clinical material to conflict/defense as the most useful. The youngster's cross-gender behavior, possible contributions to it, treatment issues, parental input, boundaries, and transitional objects are considered. The necessity of close communication, cooperation, and guidance to parents, as well as involving them in individual and family therapy, is stressed.

Child, Preschool↗
PubMed1986

Male gender identity: early developmental roots.

The purpose of this paper has been to bring together a wide variety of ideas about male gender and sexual development into a broader and updated view. Toward that end, I have suggested that we view the concept of gender identity along three intertwining strands; core gender identity, gender role identity, and choice of love object. I have also suggested some important contributions made to each of these strands at various phases of development. I have concentrated upon the early childhood roots of gender identity, particularly as the earliest years are the time when important internal structures are established and consolidated. Later manifestations, although not the same as the early ones, have their roots in the early childhood configurations. However, the contributions to an overall broad sense of gender identity made during the latency and adolescent years must not be overlooked. The final outcome of any position along any of the strands is not finally consolidated until the end of adolescence. Indeed, adult experiences may also make important contributions.

Adult↗
PubMed1994

Identity formation in adolescence: case study of gender identity disorder and treatment through an intermediate-care day hospital.

A review of the literature on gender identity disorders is integrated with a case study presentation of a psychiatrically disturbed nineteen-year-old transvestite youth. Accommodations and interventions made both with this patient and in the day care program for psychiatrically disturbed youths that allowed him to live at home and be maintained despite severe pathology are discussed.

Adolescent↗
PubMed2004

Does gender identity influence children's psychological well-being?

This study examined influences of gender identity on change in preadolescents' adjustment over time. In each of two successive years, three measures of gender identity (felt gender typicality, contentment with gender assignment, and felt pressure for gender conformity) and four measures of adjustment (self-esteem, internalizing symptoms, externalizing symptoms, and acceptance by peers) were collected. Low gender typicality, low gender contentedness, and high felt pressure all foreshadowed deterioration on one or more indexes of adjustment. The combination of low gender typicality with high felt pressure was especially conducive to internalizing problems, underscoring the importance of the cognitive organization of the gender identity variables. The advantages of a multidimensional perspective on gender identity are discussed.

Child↗
PubMed1993

A gender identity interview for children.

A 12-item gender identity interview schedule was administered to 85 children referred for concerns regarding their gender identity development and 98 clinical and normal control children. Factor analysis identified two factors, which were labeled Affective Gender Confusion and Cognitive Gender Confusion. The gender-referred group gave significantly more deviant responses than did the controls on both factors. Results were discussed with regard to several diagnostic and assessment issues pertaining to children with gender identity disorder.

Child↗
PubMedDate not supplied

The development of gender identity in the autistic child.

The Michigan Gender Identity Test (MGIT) was administered to 30 autistic children to determine whether autistic children could demonstrate a sense of gender identity. The results of the MGIT were correlated with other developmental indices obtained from the Alpern-Boll Developmental Profile. From this sample of autistics, a significant relationship was found between gender identity and mental age, chronological age, communication skills, physical skills, social skills, self-help skills and academic (cognitive skills.

Autistic Disorder↗
PubMed2004

Prenatal androgenization affects gender-related behavior but not gender identity in 5-12-year-old girls with congenital adrenal hyperplasia.

Gender assignment of children with intersexuality and related conditions has recently become highly controversial. On the basis of extensive animal research and a few human case reports, some authors have proposed the putative masculinization of the brain by prenatal hormones-indicated by the degree of genital masculinization-as the decisive criterion of gender assignment and have derived the recommendation that 46,XX newborns with congenital adrenal hyperplasia (CAH) and full genital masculinization should be assigned to the male gender. The purpose of this study was to test in CAH girls of middle childhood the assumption that prenatal androgens determine the development of gender identity. Fifteen girls with CAH (range of genital Prader stage, 2-4/5), 30 control girls, and 16 control boys (age range, 5-12 years) underwent 2 gender-play observation sessions, and a gender identity interview yielding scales of gender confusion/dysphoria. About half a year earlier, mothers had completed 2 questionnaires concerning their children's gender-related behavior. The results showed that, as expected, CAH girls scored more masculine than control girls on all scales measuring gender-related behavior, with robust effect sizes. By contrast, neither conventionally significant differences nor trends were found on the 3 scales of the gender identity interview. We conclude that prenatal androgenization of 46,XX fetuses leads to marked masculinization of later gender-related behavior, but the absence of any increased gender-identity confusion/dysphoria does not indicate a direct determination of gender identity by prenatal androgens and does not, therefore, support a male gender assignment at birth of the most markedly masculinized girls.

Adrenal Hyperplasia, Congenital↗
PubMed2003

[Clinical characteristics and gender identity among eating disordered patients subtypes].

BACKGROUND: Gender identity is a relevant issue in the approach to eating disorders. AIM: To compare psychological and behavioural characteristics and traits of gender identity among women with eating disorders and its subtypes and non eating disordered female subjects. MATERIAL AND METHODS: An structured clinical interview based on the DSM-IV diagnostic criteria for eating disorders, the EAT-40 (Eating Attitudes Test), the Eating Disorders Inventory (EDI) and the Bem Sex Role Inventory (IBRS) were administered to 58 compulsive-purgative anorectics (AN/BN group), 15 restrictive anorectics (AN group), 33 patients suffering from eating disorder not otherwise identified, 33 purgative bulimics and to 82 female students without eating disorders. RESULTS: Patients with eating disorders ranked significantly higher on the EAT-40 and EDI and all its items (p < 0.001). The AN/BN group ranked significantly higher on the EDI (p < 0.001) and on Drive for thinness, Perfectionism and interpersonal distrust (p < 0.001). The AN group ranked higher on Maturity fears (p < 0.001). The BN group ranged higher on Body dissatisfaction, Ineffectiveness and Interoceptive awareness (p < 0.001). Patients with eating disorders were significantly identified with Feminine category and subjects without eating disorders with Androgynous and Undifferentiated categories on the IBRS (p = 0.002). The AN group showed the highest percentage on Feminine category and the lowest on Androgynous and Undifferentiated categories. All the groups rejected and approved feminine, masculine and neutral qualities. CONCLUSIONS: Femininity emerged as the main trait of gender identity in patients suffering from eating disorders, in contrast to androgyny, showed by healthy women.

Adult↗
PubMed1994

The concept of gender identity disorder in childhood and adolescence after 39 years.

The term "gender role" appeared in print first in 1955. The term "gender identity" was used in a press release, November 21, 1966, to announce the new clinic for transsexuals at The Johns Hopkins Hospital. It was disseminated in the media worldwide, and soon entered the vernacular. The definitions of gender and gender identity vary on a doctrinal basis. In popularized and scientifically debased usage, sex is what you are biologically; gender is what you become socially; gender identity is your own sense or conviction of maleness or femaleness; and gender role is the cultural stereotype of what is masculine and feminine. Causality with respect to gender identity disorder is subdivisible into genetic, prenatal hormonal, postnatal social, and postpubertal hormonal determinants, but there is, as yet, no comprehensive and detailed theory of causality. Gender coding in the brain is bipolar. In gender identity disorder, there is discordancy between the natal sex of one's external genitalia and the brain coding of one's gender as masculine or feminine.

Adolescent↗
PubMed1990

Stereotypic and nonstereotypic sex role trait and behavior orientations, gender identity, and psychological adjustment.

This study examines the relations among sex role trait and behavior orientations, gender identity, and psychological adjustment in order to test traditional and contemporary perspectives regarding the adjustment implications of stereotypic and nonstereotypic sex role trait and behavior orientations. Measures of sex role personality traits and behaviors and scales assessing depression, anxiety, and social maladjustment were administered to 235 college men and women. In addition, subjects completed measures of gender identity and gender adequacy. Contrary to traditional perspectives, androgynous men and women and cross-sex-typed women were no less well adjusted than sex-typed individuals. However, consistent with traditional perspectives, men who were low in masculine characteristics (and men and women low in both masculine and feminine characteristics) did appear less well adjusted on measures of depression, anxiety, and social maladjustment. Furthermore, low masculinity men had less secure gender identities. No such gender identity disturbances were found in women.

Adaptation, Psychological↗
PubMed2001

Handedness in boys with gender identity disorder.

Handedness preference was assessed in 205 boys with gender identity disorder and 205 clinical control boys referred for other reasons. Boys with gender identity disorder were significantly more likely to be left-handed than the clinical control boys (19.5% vs. 8.3%, respectively). The boys with gender identity disorder, but not the clinical control boys, also had a significantly higher rate of left-handedness compared to three independent, general population studies of nonreferred boys (11.8%; N = 14,253) by Hardyck, Goldman, and Petrinovich (1975), Calnan and Richardson (1976), and Eaton, Chipperfield, Ritchot, and Kostiuk (1996). Left-handedness appears to be a behavioral marker of an underlying neurobiological process associated with gender identity disorder in boys.

Child↗
PubMed2005

Self-characterizations of adult female informal caregivers: gender identity and the bearing of burden.

Gender identity is a powerful aspect of self that shapes values, attitudes, and conduct. Family caregivers, particularly women, tend to forgo institutionalization of care recipients even when care demands are overwhelming. The reluctance of women to relinquish care raises questions about the relationship between gender identity and the bearing of burden. To illuminate the relationship between gender and burden, 36 adult women caring for highly dependent adults were asked to describe the nature of "self"; that is, how they characterized themselves as a person. Results were tabulated and critically examined in relation to stereotypical gender traits, as well as social and political processes that create gender dichotomies. Overall, self-characterizations indicated caregivers had internalized stereotypical female gender traits that support and facilitate the enduring of burden.

Activities of Daily Living↗
PubMed1982

Two types of cross-gender identity.

A revision of the typology of male cross-gender identity was carried out by means of formalized, easily replicable methods. The results suggest (1) that there are two discrete types of cross-gender identity, one heterosexual, the other homosexual; (2) that transvestism, and closely related conditions of cross-gender identity, occur exclusively or almost exclusively in heterosexuals; (3) that of the two types of transsexualism distinguished in this study, type A is, in heterosexuals, very rare or completely nonexistent; (4) that (in the course of time) transvestites or borderline transsexuals (defined below) may develop sustained cross-gender identity, as observed by Stoller (1971); (5) that although, according to Hoenig and Kenna (1974), transsexualism by itself is not an anomalous erotic preference, it is (virtually) always either preceded by transvestism or accompanied by homosexuality or cross-gender fetishism.

Adult↗
PubMed2007

Gender identity and adjustment in black, Hispanic, and white preadolescents.

The generality of S. K. Egan and D. G. Perry's (2001) model of gender identity and adjustment was evaluated by examining associations between gender identity (felt gender typicality, felt gender contentedness, and felt pressure for gender conformity) and social adjustment in 863 White, Black, and Hispanic 5th graders (mean age = 11.1 years). Relations between gender identity and adjustment varied across ethnic/racial groups, indicating that S. K. Egan and D. G. Perry's model requires amendment. It is suggested that the implications of gender identity for adjustment depend on the particular meanings that a child attaches to gender (e.g., the specific attributes the child regards as desirable for each sex); these meanings may vary across and within ethnic/racial groups. Cross-ethnic/racial investigation can aid theory building by pointing to constructs that are neglected in research with a single ethnic/racial group but that are crucial components of basic developmental processes.

Adaptation, Psychological↗
PubMed1996

Traits of separation anxiety in boys with gender identity disorder.

OBJECTIVE: To assess the presence of traits of separation anxiety disorder in boys referred clinically for gender identity disorder. METHOD: One hundred fifteen boys were referred to a specialty clinic for concerns about their gender identity development. They were divided into two subgroups: one group met the complete diagnostic criteria for gender identity disorder; the other group did not meet the complete diagnostic criteria. The mothers of the boys were administered a structured interview schedule pertaining to separation anxiety disorder according to DSM-III criteria. RESULTS: A conservative definition of separation anxiety disorder showed no significant association with gender identity disorder; however, a liberal definition of separation anxiety disorder showed that it occurred significantly more often in the subgroup of boys who met the complete criteria for gender identity disorder than in the subgroup who did not meet the complete criteria (64.4% versus 38.1%, respectively). CONCLUSIONS: Boys with gender identity disorder show a high rate of co-occurring traits of separation anxiety. Reasons for this linkage require additional empirical study.

Anxiety, Separation↗